Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med, Path, Pharm > test 7 > Flashcards

test 7 Flashcards

1
Q

Obstructive Lung Disease definition

A

Conditions that make it hard to exhale all the air in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of obstructive lung disease

A

Asthma, COPD (emphysema, chronic bronchitis), bronchiectasis, cystic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4th leading cause of death in US

A

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

COPD triad

A

chronic bronchitis, emphysema, asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chronic inflammation and thickening of the walls of the bronchial tubes with excess mucus

A

Chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Abnormal, permanent enlargement of the alveoli, accompanied by destruction of their walls and without obvious fibrosis

A

Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the three main issues with COPD?

A

airway inflammation
mucociliary dysfunction
consequent airway structural changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of COPD other than smoking

A

environmental factors, airway hyperresponsiveness, alpha 1-antitrypsin deficiency, IVDU, HIV, GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

alpha 1 antitrypsin function

A

made in liver, protects lung parenchyma from elastolytic breakdown. Deficiency causes COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most common non-infectious pulmonary dz among HIV pts

A

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presence of _____ in 28% of COPD pts and increases risk of hospitalization.

A

GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common variable to grade severity of COPD

A

FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the best single predictor of airflow obstruction?

A

Hx of >40 pack years smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

COPD presentation (4)

A

DOE
Productive cough (worse in am)
Acute chest illness
Wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Hoover sign?

A

Accessory muscle use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

COPD PE: Breath sounds

A

Wheezing
Diffusely decreased breath sounds
Prolonged expiration
Coarse crackles on inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

COPD PE: Inspection, percussion

A

Hyperinflation (barrel chest)
Hyperresonant on percussion
Peripheral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Blue Bloater

A

Chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pink Puffer

A

Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Chronic bronchitis vs. emphysema PE

A

Chronic bronchitis: obese, frequent cough, R sided heart failure
Emphysema: thin w/ barrel chest, no cough, heart sounds distant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

COPD lab findings

A

FEV1/FVC <70%
DLCO (decreased lung carbon monoxide diffusing capacity)
Increased pCO2 and HCT
Decreased pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why hematocrit is high in COPD

A

Normal amounts of oxygen can’t reach blood stream, so body adjusts by making more RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

COPD Xray findings

A

Low, flattened diaphragm
Hyperinflation
Increased AP retrosternal airspace
Narrow cardiac silhouette

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Airflow limitation

A

Inflammation –> small airway dz and parenchymal destruction –> airflow limitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

GOLD criteria for COPD

A

Symptoms (from mMRC or CAT), airflow obstruction (FEV1), and exacerbation hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

low risk with more symptoms is what category?

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

High risk with less symptoms is what category?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

High risk with more symptoms is what category?

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is a SAMA?

A

short acting anticholinergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ipratrapium

A

SAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Atrovent

A

SAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Serious reactions: bronchospasm, anaphylaxis, hypokalemia

A

SABA + SAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Serious reactions: a-fib, hypokalemia

A

SABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Albuterol, ventolin, proventil

A

SABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

relaxes bronchial smooth muscle and inhibits release of immediate hypersensitivity mediators from mast cells

A

SABA and LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Reduces need for rescue medication. 21% reduction in exacerbations.

A

LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Salmeterol, formoterol, serevent, foradil

A

LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Serious rxn: bowel obstruction, bronchospasm, glaucoma

A

LAMA, SAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Tiotropium

A

LAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Spiriva

A

LAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Preferred once a day agent for COPD

A

LAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Preg. Cat for SAMA and LAMA

A

SAMA: B
LAMA: C

43
Q

Adverse effects: pharyngitis, diarrhea, extremity pain

A

LAMA + LABA

44
Q

Serious Rxn: asthma related death, anaphylaxis, HTN, hypokalemia, prolonged QT

A

LAMA + LABA

45
Q

Umeclidium/vilanterol

A

LAMA + LABA

46
Q

Anoro Ellipta

A

LAMA + LABA

47
Q

Wait at least a minute before using another inhaler

A

LAMA + LABA

48
Q

Serious rxns: hypokalemia, glaucoma, cataracts, death

A

ICS + LABA

49
Q

Formoterol/budesonide
Salmeterol/fluticasone
Formoterol/mometasone

A

ICS + LABA

50
Q

Symbicort, Advair, Dulera

A

ICS + LABA

51
Q

Thought to reduce neutrophil and eosinophil counts in the lungs

A

PDE4i

52
Q

Adverse effects: decrease in weight, GI upset, influenza, backache, dizziness, HA, insomnia

A

PDE4i

53
Q

Serious rxn: suicidal thoughts

A

PDE4i

54
Q

Roflumilsat

A

PDE4i

55
Q

Daliresp

A

PDE4i

56
Q

Not generally recommended for COPD

A

Theophylline

57
Q

Serious rxn: a-fib, SJS, seizures

A

theophylline

58
Q

Complications of COPD

A 
Resp. infx
Pulmonary HTN
Increased risk of heart disease and GERD
Lung cancer
Depression (40% are severely affected)
59
Q

What’s added to convention COPD therapy to reduce frequency of common cold, which can trigger COPD exacerbations?

A

PPIs

60
Q

Define chronically hypoxic

A

Resting O2 <90% w/ pulm htn or R heart failure

61
Q

Vaccines for COPD pts

A

Pneumococcal >65

Influenza in all COPD pts

62
Q

Chronic COPD infxn colonization

A

S. pneumoniae
H. influenza
M. Catarrhalis

63
Q

Severe COPD infx colonization

A

P. aeruginosa

64
Q

“relievers”

A

SABA, anticholinergics

65
Q

“controllers”

A

LABA

66
Q

“Preventers”

A

ICS, LTRAs

67
Q

Abnormal, permanent dilation/destruction of bronchi walls

A

Bronchiectasis

68
Q

Important cause of lung dz in developing countries and was a common fatal condition before abx

A

Bronchiectasis

69
Q

“Lady Windermere” syndrome

A

bronchiectasis

70
Q

Bronchiectasis most common demographic

A

female, white, slender, >60

Vit. D deficiency is common (vit D deficient with bronchiectasis means P. aeruginosa likely)

71
Q

Causes of bronchiectasis

A

acquired more common: infection, airway obstruction, impaired drainage, toxic gas exposure, CF
Congenital

72
Q

Bronchiectasis: Affected bronchi show 4 things

A

transmural inflammation
mucosal edema
craters
ulcers

73
Q

Culprits of bronchiectasis infection

A 
S. pneumonia
S. aureus
H. influenza
M. tuberculosis
P. aeruginosa
M. avium
M. catarrhalis
RSV
74
Q

GERD or aspiration pneumonia are what etiology of bronchiectasis?

A

airway obstruction

75
Q

CF, Primary ciliary dyskinesia, and allergic bronchopulmonary aspergillosis (ABPA) are what etiology of bronchiectasis?

A

impaired drainage

76
Q

Toxic gas exposure is commonly what?

A

chlorine, ammonia

77
Q

Causes 1/3 of all bronchiectasis

A

Cystic Fibrosis

78
Q

Causes 1/3 of bronchiectasis that is not CF

A

Sequela of necrotizing infxns that are not treated properly or not treated at all

79
Q

Clinical manifestations of bronchiectasis

A

Dyspnea, pleuritic chest pain, wheezing, fever, weakness, weight loss

80
Q

Bronchiectasis: PE auscultation

A

Crackles
Rhonchi
Wheezing
Inspiratory squeaks

81
Q

Bronchiectasis: PE inspection

A

digital clubbing
cyanosis
wasting
weight loss

82
Q

What confirms bronchiectasis?

A

high resolution CT

83
Q

Treatment of bronchiectasis?

A
  1. Control infection with fluoroquinolones
  2. Reduce inflammation
  3. Improve bronchial hygiene
84
Q

What’s used to reduce inflammation in bronchiectasis?

A

B2 agonists
Anti-cholinergics
Inhaled Corticosteroids

85
Q

How do you improve bronchial hygiene?

A

Airway mucus clearance via chest percussion and postural drainage

86
Q

What do you use to treat infx of bronchiectasis?

A

fluroquinolones

87
Q

Dz of endocrine gland, mucus blocks bronchi, pancreatic ducts, and intestines

A

CF

aut. recessive, chromosome 7

88
Q

Most common lethal hereditary disease in the white population

A

CF

median age of dx is 6-8 months, 2/3 dx by 1

89
Q

what gene has a defect in CF?

A

Protein transmembrane conductance regulator (CFTR)

90
Q

Clinical manifestations of CF

A

severe lung dz, pancreatic insufficiency, nasal polyposis, sinus dz, meconium ileus (obstruction), rectal prolapse, chronic diarrhea, pancreatitis, cholelithiasis, cirrhosis

91
Q

CF PE (pulm)

A

rhinitis, nasal polyps, cough (worse at night), tachypnea, resp. distress, wheezes, crackles

92
Q

CF PE (inspection, percussion)

A

Increased AP diameter
Clubbing
Cyanosis
Hyperresonant chest

93
Q

CF PE (GI)

A 
Abd. distension
Hepatosplenomegaly (portal htn)
Rectal prolapse
Dry skin (vit A deficiency)
Cheilosis (vit. B deficiency)
94
Q

CF PE (urogenital)

A

Males: undescended testicles, hydrocele, absence of vas deferens (>95% of men are sterile)
Females: Severe nutritional deficiency–amenorrhea. 20% infertile

95
Q

CF PE (other)

A

scoliosis, kyphosis, swelling of submandibular or parotid gland, aquagenic wrinkling of palms (AWP)

96
Q

Effects of CF

A

Sinusitis, hemoptysis, pneumothroax (ruptured alveoli), pancreatic insufficiency, diabetes, cholelithiasis, weak muscles, stress incontinence, osteoporosis, infertility

97
Q

Diagnosis of CF

A

positive sweat chloride test (>60 mEq/L) or positive genetic test AND 1 of the following:
COPD, pancreatic insufficiency, positive family hx

98
Q

Goals of CF treatment

A

maintain lung fxn, nutritional therapy, manage complications

99
Q

What’s used to control respiratory infection in CF patients?

A

Cipro, azithromycin, aerosolized gentamycin or tobramycin if there’s resistance

100
Q

What infections are CF patients predisposed to?

A

S. aureus, P. aeruginosa

101
Q

What’s used to help CF patients clear airways of mucus?

A

Bronchodilator before chest physiotherapy, mucolytic (dornase alfa, pulmozyme + hypertonic saline solution aerosols)

102
Q

What nutritional therapy is given to CF patients?

A

Fat soluble vitamins, pancreatic enzymes, high energy, high fat diet

103
Q

Ivacaftor (Kalydeco)

A

CFTR potentiator that targets defective protein in CF.

104
Q

Repeated chest infx in young person with upper lobe bronchiectasis

A

Consider CF

Clin Med, Path, Pharm (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions